Negative Vet...

Discussion in 'Feline Health - (Welcome & Main Forum)' started by KyraCat, Jul 31, 2020.

  1. KyraCat

    KyraCat Member

    Joined:
    Jul 1, 2020
    Hi All - hoping for some encouragement here having just spoken to the vet.

    So we had a Fructose test done 3 weeks ago and the results were just high, so we upped Kyra from 3.5 to 4 and have since gone up to 4.5. I think we are doing really well on this - yes the insulin is peaking too early but in general Kyra's numbers are so much better than they were back when we were taking him to the vets every fortnight, his coat has improved, he is drinking much less water and he is loving his brother and sister again.

    I don't know if the vet is just a natural pessimist but he didn't have one good thing to say about Kyra's numbers despite the improvements (though not perfect!) Instead he mentioned another fructose test at £100 a go!
    He has asked I do a curve on Sunday, which I am more than happy to do. But when I asked if doing the curve would stop the need for the fructose test (as I can't keep affording to pay for them - and that makes me feel like the worst owner in the world) he openly said I'm not going to answer, lets see what the curve shows.

    Is it me?! Am I delusional to think Kyra has come a long way from where we were only a few weeks ago? Is the vet just having me on and trying to get me to pay out everything I can?

    It's gotten me really down after actually looking forward to hearing what the vet had to say having not seen Kyra for 3 weeks and the improvement to his numbers.

    My mood has dropped so low after that - I think I could need a new vet...
     
  2. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    If you like this vet other than the FD doom-n-gloom, you could always do what a lot of us do, smile and nod in the office, then go your own way with the FD treatment. But it does sound like this vet might have an attitude that is hard to deal with, so if I were you I'd probably be looking around for a new one.

    In any case, NO you do not need to keep paying for fructosamine tests!!!!!!! They are useless for anything but an initial diagnosis. They only give a very rough idea of what is going on, averaging glucose levels across a couple weeks. You are getting way better information with your BG testing. The fact that your vet keeps insisting on more fructosamine tests that you can't afford, even with this info, is a bad sign. Either he only knows how to deal with the fructosamine test and can't interpret your BG data, or else he wants to charge you for the test. Don't do it. If he insists, then it really is time for a new vet.

    You are doing a wonderful job with the home testing on your own, better than this vet's advice it seems. With the information you are gathering, people here can help with the dosing. I personally am not comfortable giving Caninsulin recommendations, but others can.

    I can at least make a couple suggestions on testing. You've got some great daytime data at +3 and +5 [oops-- I can't count, it's +3 and +6!]. I would suggest mixing up the times a bit-- getting +2's and +4's on some days. Caninsulin tends to hit early in the cycle, and sometimes nadirs (hits the lowest point) around +4, so those tests might give you a fuller picture of what's going on. I'd also suggest trying to always get at least one test at night if your circumstances allow it-- many cats go lower at night than the day.

    Please don't let this vet bully you and shake your confidence-- you are doing fantastic! :bighug: :bighug:
     
    Last edited: Jul 31, 2020
  3. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Jemma
    I would not get another fructosamine test done. It is completely unnecessary when you are home testing. I would also ask about swapping to a more suitable insulin. Caninsulin is for dogs. I believe Prozinc is hard to come by in the uk at the moment but ask about Lantus. It’s a great insulin for cats and many cats who do not do well on caninsulin (which has a duration which is too short for cats) do really well on Lantus.
     
  4. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    It sounds like your vet RELIES on these tests which shows how much actual teaching they get on this subject. Nothing worse than a vet who wont admit they dont know EVERYTHING. :rolleyes:

    If you do like this Vet might I suggest you broach the subject of "Learning Kyra together" Thats what my vet told me and we did.
    He may be cash oriented and thats why he keeps pushing???
     
  5. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Canin "e" insulin ...nuff said
     
  6. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    The fructosamine test is just an average. It's helpful for diagnosis but not really helpful after that. Daily testing is what is going to tell you how she's doing.
     
  7. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    It's clear that this insulin is not lasting long enough for your cat. I would suggest getting on a longer acting insulin.
     
  8. KyraCat

    KyraCat Member

    Joined:
    Jul 1, 2020
    Thanks so much everyone! You have really given me the push I need to move on to another vets! We have an appointment on Thursday with a vet my mom takes her 6 cats to. I will still do the curve on Sunday and I'll be sending that and Kyra's SS to the new vets to go with the history the current vets have for him.

    I feel confident moving to a new vets knowing I have a lot more knowledge now, thanks to all of you on this group, meaning I won't be pushed around by someone who potentially doesn't know half of the amazing things you all suggest.

    I honestly can't tell you how much your quick and supportive answers have helped me and boosted me back up so quickly!

    @JanetNJ I know! The vet half commented on that then mentioned the possibility of doing 3 shots a day instead of 2, rather than trying another insulin. I believe his reasoning was it would mean us "starting from scratch" Personally I think if he does have any experience with Diabetes it's in dogs, not cats, as all of his references seem to be about dogs he has dealt with.
     
  9. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    We share your thoughts!
    GOOD LUCK! with your new Vet. Shhhhhh He has many eyes on him. ;):p
     
  10. Tina Marie and Jan

    Tina Marie and Jan Well-Known Member

    Joined:
    Jul 24, 2019
    Hello, and just a side note -
    We had an "expert" on canine diabetes join the Lantus forum last year, because her cat got diabetes.
    Treating felines is very different, and it sounds like FD is new to your vet. The new member learned just how different treating a cat was.
    I agree with the others about NOT needing to pay for the fructosamine test on a continual basis.
    Kisses or scritches for Kyra!
     
  11. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
  12. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
  13. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    You wouldn’t have to start from scratch. You might go down 0.5 units or maybe 1 just to play safe but that’s about it. I’m so glad we could help.
     
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  14. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Jemma,

    Whoa, Nelly!! :eek:

    While it is technically feasible to do a three-doses-a-day regimen with Caninsulin - and may in some instances be the only option a caregiver has open to them - in practice it can be a waking nightmare (with the emphasis very much on the waking bit). It's the sort of thing one would hesitate to inflict on one's worst enemy, and not to be given much consideration when there are more cat-suited insulins available.

    [Emphasis mine]

    Those are not the words or behaviours of a physician brimming with confidence in their ability to treat feline diabetes, IMHO.

    Very glad to hear you've found a new vet. I agree with other members that the feline diabetes knowledge of the vet you're moving on from leaves a lot to be desired.


    Kyra has answered that question for you:

    We look at the numbers to guide us, but the whole point of all this malarkey is to make our kitties feel better. I reckon Kyra thinks you're doing a grand job. :cat:


    Mogs
    .
     
    Last edited: Aug 1, 2020
  15. KyraCat

    KyraCat Member

    Joined:
    Jul 1, 2020
    Thanks again everyone!

    I am just about to write my email to the new vets and I'll be including Kyra's SS. As you'll see we attempted our first curve today but stopped after the +7 result as it was already going pretty high up. Could be stress as we have been bugging him all day but then he has been happy to have lots of loves after each test - who knows!

    We'll do a test at +10 and of course before is evening injection, just to see how he has been in the latter half of the cycle.

    Whether rightly or wrongly I am feeling more optimistic going in to this week knowing we are trying a new vet for Batman (one of Kyra's many nickname :))
     
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  16. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    ME TOOOOO
     
  17. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    At his feeding time, do you call "Dinner, dinner, dinner, dinner"?


    (I'll get me coat...)

    ;) :D


    Mogs
    .
     
  18. KyraCat

    KyraCat Member

    Joined:
    Jul 1, 2020
    Hahahah I didn't - but I may start to :p
     
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  19. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I now have visions of Kyra doing kitty rolleyes. :cat:

    BTW, fingers and paws crossed over here in the Shire for a good visit with the new vetty bean. Be sure to let us know how you get on. :)


    Mogs
    .
     
  20. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Hello, we too started on Caninsulin (in Canada though). And also had short duration with Neko howling for food at meal times cause her numbers were so high by then. I stopped doing fructosamines after three of them, figured I'd rather spend the money on test strips. At 5 units of Caninsulin we switched to Lantus, sadly at too low a dose. Took me a few months to get back where I should have been. My vet also didn't know as much on feline diabetes - I was the first client to home test. But I showed her the dosing methods and my spreadsheet - and she trusted me (long time vet), so we worked together and learned together.

    To arm you with a little something for discussion on another insulin - here is a post by Eliz with a link to a video podcast by folks at the Royal Vet College Diabetes Remission Clinic, probably the leading researchers in FD right now. The vet also talks about Levemir/determir, another good insulin option for kitties on higher doses. Some cats find the acid base of Lantus stings at higher doses.
     
  21. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    You are NOT delusional!!! There are quite a few of us who spend our free time looking at spreadsheets. We'd tell you if you were hallucinating or delusional. We tend to be pretty blunt about such things!!

    The only thing I would suggest is getting a "before bed" test every night. It will help you to sleep a bit better knowing that Kyra is in safe numbers. Many cats tend to have lower numbers during the PM cycle. In addition, if you don't get any tests at night, you're missing half of your data.

    As @Critter Mom (Mogs) noted, three times a day (TID) dosing is a great thing if you have chronic insomnia. If you like to get a decent night's sleep, have to work, or want a life, it's quite difficult to maintain a TID dosing schedule. You're much better advised to switch to Lantus, Levemir, or Prozinc.

    My vets were similar to what Wendy experienced. My vet in Chicago had never seen the Lantus Tight Regulation Protocol. She learned it through me and then taught it to all of the other vets in the practice. When I moved to Columbus, I interviewed the vet I'm using and then showed her Gabby's spreadsheet. Her only comment was, "What do you need me for?" She has been an incredible partner in Gabby's care and in the care of my other cats.
     
  22. KyraCat

    KyraCat Member

    Joined:
    Jul 1, 2020
    Hi all!

    Thanks so much for your messages they really picked my spirits up quickly last week after speaking to Mr Negative!

    We "saw" a new vet yesterday, much more positive about Kyra's readings, water in take and the fact we are home testing!! She has upped us to 5 units, as she said we still need to get the numbers a little lower if we can, and has given us 2-3weeks to see how that goes then if it still doesn't seem to be doing the trick we can look in to caninsulin a bit further (wasn't sure what she meant by that but can ask when the time comes) or we can look in to changing insulin. I'm not gonna get ahead of myself thinking this is the vet for us but I feel much much better after speaking to her compared to the last one.

    We have started the 5 units as of this morning and I'll do a test around +2/+3 as that is when is usually hits Kyra the hardest.

    @Sienne and Gabby (GA) I have found myself looking at others spreadsheets now - I find them fascinating to see the different stages people are at and how much things can change for each cat from one week to the next! I don't know if you saw but I did another (2hourly) curve on Wednesday and the caninsulin worked for the 6 hours!! I'm pretty sure it was a fluke though lol!!

    Thank you all again! You really did wonders for me and my spirit, and Kyra, of course! :)
     
  23. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    You are seeing some better numbers -- and some bouncing, which is normal. The lows can cause a kitty's pancreas and liver to overreact and cause numbers to spike (aka a "bounce").

    A couple of things... Please get a test past your PM +2 if you see a 200 point drop. Caninsulin can cause numbers to drop fast and hard. You want to make sure it's safe for you to go to sleep when you see a big drop.

    Because Caninsulin has a fast onset, we tend to be more conservative than your vet and raise doses by 0.25u. Please make sure you have high carb food on hand in case it's needed to steer low numbers.

    We also use 90 as a dose reduction point. You may want to clarify with your vet what s/he uses to signal a reduction. Based on the 85 yesterday, Kyra's dose should be reduced to 4.75u.
     
  24. KyraCat

    KyraCat Member

    Joined:
    Jul 1, 2020
    Thanks Sienne! Yes big change in the numbers already. Luckily I'd read in here about bounces so wasn't worried (upset) that he had such a high reading pmps last night.

    Thank you for the note about the additional reading after the 200 drop. I'll make sure to do this in future! I have my emergency kit already in case it's needed.

    The 85 reading was only this afternoon. Even though it has already gone up to 200 (and will continue to incase) would you still suggest dropping the does to 4.75 tonight? Or should I check back here tonight once I have his pmps reading?

    Thanks so much for your help here x
     
  25. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    With Caninsulin, you should be fine to decrease. I'm always concerned with the faster acting insulin that there can be a swift response and numbers tank. Ideally, you find a dose that lowers the overall range and then can gradually keep lowering the range without having the wide swings in numbers. It's harder to achieve this with a fast acting insulin that has limited duration.
     
  26. KyraCat

    KyraCat Member

    Joined:
    Jul 1, 2020
    I feel like I found a thread the other day with images of the syringes and where to draw up to when doing .25 measures.

    Have I imagined it? I can't find it now... Could some one direct me to it please and thanks
     
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  27. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    You might want to start a new thread asking that specifically. You will get more eyes on the subject that way ;)
     
  28. KyraCat

    KyraCat Member

    Joined:
    Jul 1, 2020
    Good thinking Jeanne!

    I never know when is best to start a new thread... I have your permission so I'm doing it lol
     
  29. MamaLovesMomo

    MamaLovesMomo Member

    Joined:
    May 18, 2020
    Hi,
    I am new here. But @jt and trouble (GA), @Nan & Amber (GA), are always been very supportive to me.. guiding me on all my concerns to my MM. I totally agree with them- caninsulin is not good for cats, and if you are already testing at home- why need fructosamine test? Try another insulin if you can afford.
    Lantus is a good one.. (just very expensive)... but Each Cat is Different.
    Hope the best for Kyra
     
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  30. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    LOL you dont need to ask permission to start a new thread. I do it all the time :p (In Community);)
     
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  31. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    For general information, that is a sweeping generalisation and it's not accurate. While many cats may do better on longer-acting insulin, some cats do get on OK with Caninsulin, and may even go into remission after treatment with it. As you correctly observe in your post, ECID. :)


    Mogs
    .
     
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